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건강근로자효과 보정 전후의 메타 분석 결과 비교-직업적 트리클로로에틸렌 노출과 암의 연관성-

Comparison of Meta-analysis Results with and Without Adjustment for Healthy Worker Effect on the Association Between Occupational Exposure to Trichloroethylene and Cancer Risk

황성호|이경무|박태원
한국환경보건학회 (Korean Society of Environmental Health)|2014.10|한국환경보건학회지 (JOURNAL OF ENVIRONMENTAL HEALTH SCIENCES)|제40권 제5호|pp. 385-396|DOI http://dx.doi.org/10.5668/JEHS.2014.40.5.385

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키워드

Meta-analysisCancerTrichloroethyleneSMRHealthy worker effectrSMR

초록

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) forworkers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the samemethods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma(NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reportingSMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and95% confidence intervals. Relative SMR (rSMR=SMRx/SMRnot x) was calculated comparing observed andexpected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of valuesconsisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy workereffect for the selected studies. When the healthy worker hire effect was taken into account, the summarized riskbecame statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMRof all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMRof NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summaryrSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and thesummary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect throughmeta-analysis.

Abstract

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) forworkers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the samemethods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma(NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reportingSMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and95% confidence intervals. Relative SMR (rSMR=SMRx/SMRnot x) was calculated comparing observed andexpected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of valuesconsisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy workereffect for the selected studies. When the healthy worker hire effect was taken into account, the summarized riskbecame statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMRof all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMRof NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summaryrSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and thesummary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect throughmeta-analysis.

참고문헌 (25)

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